Hemodiyaliz için arteriyovenöz fistül oluşturulmasında lokal anestezi ve bölgesel blok anestezi tekniklerinin karşılaştırılması

Year 2021, , 154 - 160, 01.09.2021

Ufuk Turan Kürşat Korkmaz

https://doi.org/10.34084/bshr.972743

Abstract

Amaç: Kronik böbrek hastalığı olan hastalarda hemodiyaliz için arteriyovenöz fistül (AVF) oluşturulmasında lokal anestezi ve bölgesel anestezi tekniklerini karşılaştırmayı amaçladık.
Araçlar ve Yöntem: AVF oluşturulmuş toplam 90 hasta bölgesel ve lokal anestezi gruplarına ayrıldı. Fistüllerin postoperatif komplikasyonları, maturasyon süresi ve çalışma durumu kaydedildi ve iki grup arasında karşılaştırıldı. Tüm hastalar altı ay takip edildi. AVF oluşturma işlemi, sefalik venin, lokal veya bölgesel anestezi altında el bileğinin radiyal arterine şantlanmasıyla gerçekleştirildi.
Bulgular: Gruplar arasında yaş (p = 0.209) ve cinsiyet (p = 0.455) açısından anlamlı fark bulunmadı. En sık karşılaşılan postoperatif komplikasyonlar ağrı, hematom ve enfeksiyondu. Postoperatif komplikasyonlar açısından gruplar arasında anlamlı fark yoktu (tümü için p> 0.05). Fistüllerin çalışma durumu açısından gruplar arasında istatistiksel olarak anlamlı bir fark gözlenmedi (tümü için p> 0,05). Bölgesel blok anestezi uygulanan hastalarda medyan olgunlaşma süresi istatistiksel olarak anlamlı derecede daha kısaydı (p <0,001).
Sonuç: Tüm hastalar oluşturulan fistüller yoluyla başarılı bir şekilde hemodiyaliz aldı. Bölgesel blok anestezi ile fistül olgunlaşma süreleri kısaldı. Daha kısa medyan olgunlaşma süresi bölgesel anesteziyi lokal anesteziye göre daha üstün kılmaktadır. Ancak bu konuda henüz fikir birliği olmadığı için konuyla ilgili çalışmalara devam etmekte fayda görülmektedir.

Keywords

hemodiyaliz, arteriovenöz fistül, maturasyon, bölgesel anestezi, lokal anestezi

Comparison of local anesthesia and regional block anesthesia techniques in the creation of arteriovenous fistulas for hemodialysis

Abstract

Abstract
Objective: To compare local anesthesia and regional anesthesia techniques in the creation of AVFs for hemodialysis in patients with chronic kidney disease.
Methods: A total of 90 patients who underwent AVF creation were divided into regional and local anesthesia groups. Postoperative complications, maturation time and running status of the fistulas were recorded and compared between the two groups. All patients were followed-up for six months. AVF creation was performed by shunting the cephalic vein to the radial artery of the wrist under either local or regional anesthesia.
Results: No significant difference was found between the groups in terms of age (p=0.209) and gender (p=0.455). The most commonly encountered postoperative complications included pain, hematoma and infection. There was no significant difference between the groups in terms of postoperative complications (for all p>0.05). No statistically significant difference was observed between the groups in terms of the running status of the fistulas (for all p>0.05). The median maturation time was statistically significantly shorter in patients undergoing regional block anesthesia (p<0.001).
Conclusion: All patients successfully received hemodialysis through the created fistulas. Fistula maturation times were shorter with regional block anesthesia. The shorter median maturation period makes regional anesthesia superior over local anesthesia. However, since there is no consensus on this issue yet, it would be beneficial to continue studies on the subject.

Keywords

hemodialysis, arteriovenous fistula, maturation, regional anesthesia, local anesthesia

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